Heartland Sneak Peek: Forensic Denials – DME Season 2 Episode 1

Published in Member Communities on April 26, 2022

Ronda and DanMedtrade attendees raved about season 1 of Forensic Denials so much that the lead investigators are bringing season 2 to the VGM Heartland Conference in June, and with ALL new cases to solve. 

Eagle-eyed reimbursement experts Ronda Buhrmester, from VGM & Associates, and Dan Fedor, from U.S. Rehab, will review some of the most horrific claim denials as they assemble the pieces left behind to determine the culprit. They will, along with the witnesses (the attendees), re-create the scene of the claim submission and investigate each one to determine if it was an innocent error, intentional, or something even darker.

This is an interactive session where the attendees WILL participate during the investigation of some of the most hair-raising denials (claim submission, prior authorization, post-pay audit). We will uncover what went horribly wrong from the intent of the policy to that fateful day of the denial. 

You are probably asking yourself, “What will I gain from this session?”  There will be several takeaways, like identifying the motive of the contractors when implementing medical policies into prior authorization and processing guidelines. Another takeaway will be learning how to conduct a detailed analysis of the evidence (denial) and trace it back to the policy to determine what went wrong with the objective to resurrect the current denial(s) and implement procedures to reduce (eliminate) the chance of these horrible denials in the future.

If you have any unsolved cases of your own bring them to be analyzed by the forensic team (remember no PHI).

We hope to see you at the Heartland Conference for this interactive session.  Learn more and register at vgmheartland.com.


TAGS

  1. billing & reimbursement
  2. heartland

From Our Experts

Great Opportunity: 2023 Breece Fellowship Announced thumbnail Great Opportunity: 2023 Breece Fellowship Announced The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) has once again opened applications for the George and Dena Breece Fellowship. The Latest in Billing & Reimbursement from Ronda Buhrmester: February 2023 thumbnail The Latest in Billing & Reimbursement from Ronda Buhrmester: February 2023 Read for several billing & reimbursement-specific updates regarding the oxygen policy updates, a reminder on the enrollment contractor, additional HCPCS codes added to F2F/WOPD required list, and continuous glucose monitor HCPCS codes. Timothy VanAntwerp Named Director of Retail Services for VGM & Associates thumbnail Timothy VanAntwerp Named Director of Retail Services for VGM & Associates Timothy (Tim) VanAntwerp has joined VGM & Associates as the Director of Retail Services. In his new role, Tim will focus on assisting members to meet their revenue goals through the implementation of retail sales. The PHE Will End May 11 thumbnail The PHE Will End May 11 President Biden has announced that the COVID-19 Public Health Emergency (PHE) will officially end on May 11, 2023. The PHE Will End May 11 thumbnail The PHE Will End May 11 President Biden has announced that the COVID-19 Public Health Emergency (PHE) will officially end on May 11, 2023. The PHE Will End May 11 thumbnail The PHE Will End May 11 President Biden has announced that the COVID-19 Public Health Emergency (PHE) will officially end on May 11, 2023. The Importance of CRT: From the Perspective of Ali Ingersoll, Ms. Wheelchair America 2023 thumbnail The Importance of CRT: From the Perspective of Ali Ingersoll, Ms. Wheelchair America 2023 In a guest article written by Ali Ingersoll, Ms. Wheelchair America 2023, longtime U.S. Rehab member Stalls Medical is highlighted as for their trustwortihness in Ali's journey to finding the wheelchair that best suits her. A Letter From the President, Adam Miller: January 2023 thumbnail A Letter From the President, Adam Miller: January 2023 As we look ahead to the new year, I wanted to share a few of my top priorities for OPGA this year.